Organization
LITTLE WONDERS123 LLC
Active
Organization
LITTLE WONDERS123 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE BYNUM OTR (OCCUPATIONAL THERAPIST)
(704) 752-1616
Entity
Organization
Contact information
Practice address
6917 SHANNON WILLOW RD, SUITE 300, CHARLOTTE, NC 28226-1332
(704) 752-1616
(704) 759-0799
Mailing address
6917 SHANNON WILLOW RD, SUITE 300, CHARLOTTE, NC 28226-1332
(704) 752-1616
(704) 759-0799
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4194
NC
Other
Enumeration date
02/06/2007
Last updated
02/26/2008
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